Hip pain

One of the common symptoms with which patients come to a medical facility is pain in the hip joint. The causes, treatment and possible diseases that cause such a manifestation cannot be identified without special medical care. Discomfort in any part of the musculoskeletal system can indicate the development of serious pathologies, so hip joint dysfunction should not be ignored.

Anatomy of the hip joint area

The hip joint plays an important role in motor activity. It is one of the largest human joints, capable of bearing heavy loads while standing, as well as walking upright.

Bones that form a joint

The hip joint is formed by the head of the femur and the acetabulum of the innominate bone of the pelvis - the strongest and largest parts of the human skeleton. The minimum number of anatomical elements of the joint ensures its strength and reliability, the ability to withstand body weight during movement. Most pathologies of the hip joint begin with damage to the acetabulum, the immovable part of the joint. It has the shape of a bowl, the center of which is directed upwards at a slight angle, which ensures an even distribution of the load between the bones of the pelvis.

The glenoid cavity is a strong and compact formation, which consists of 3 types of pelvic bones:

• ileus
• sciatic
• pubic

The most vulnerable area of the joint cavity is children whose bone tissue is not strong enough. Due to the presence of a small bony ridge at the edge of the socket, the head of the femur is completely immersed in the "cup", which provides strong support for the limb. The moving part of the joint is the femur (head, neck, greater and lesser trochanters). The shape of the head corresponds to the cavity of the joint cavity. It is covered with cartilage tissue, which ensures perfect alignment of the joint elements and their unimpeded sliding. In the center of the head is a strong ligament that connects the bone to the acetabulum, providing extra grip and support.

The neck emerges from the head of the femur at an obtuse angle, which ensures mobility of the joint and an even distribution of the load between the extremities. Trochanters are bony projections to which muscle tendons attach.

Fabrics and constructions

The normal functioning of the joint is ensured by a variety of structures, each of which performs its respective functions.

Blood supply, performance and reduced joint sensitivity are provided by:

1. Ligaments and tendons surround the joint on all sides, covering and protecting the femur and its neck, as well as the socket itself.
2. Cartilage covers the head of the femur and part of the acetabulum.
3. Subchondral areas are bone tissue composed of cells and connective extracellular substance.
4. The membrane or capsule of the joint is the source of a special secretion - synovial fluid to lubricate the parts of the joint.
5. The rim of the acetabulum connects the tip of the acetabulum and the transverse ligament.

The hip joint is supplied with nutrients through a fairly isolated network of vessels and arteries. The blood supply to the internal parts of the joint is provided by the acetabular branch of the obturator artery, and the capsules, ligaments and surrounding muscles are supplied by the deep femoral and gluteal arteries.

Anatomical formations located next to the hip joint

Often the cause of pain in the hip joint is damage to the anatomical structures located next to it. These items include:

1. Skin and subcutaneous tissue - the outer covering of the body
2. The muscles of the thigh, pelvis, back and buttocks provide joint mobility and additionally strengthen it from the outside
3. Extra-articular ligaments - perform a strengthening function, located around the joint capsule
4. Periarticular bursae are bundles of connective tissue that prevent friction between soft and hard tissues

Risk factors

Inflammatory processes in the pelvic area occur due to mechanical damage or damage of certain types of bacteria. In this case, both the elements of the joint and the anatomical formations surrounding them can be exposed to pathological effects.

As a rule, one or more structures become inflamed:

• skin
• muscles
• ligaments (extra-articular, femoral heads)
• periarticular bursae
• TBS capsule
• articular cartilage
• lip glue
• subchondral areas

Pain in the hip joint is often caused by harmful microorganisms that cause the development of infectious arthritis. Other reasons are also common:

• disorders of the immune system
• joint injuries due to excessive physical activity
• old times
• metabolic disorders
• other diseases

Characteristics of pain

When diagnosing hip pain, additional symptoms play an important role, which may indicate the root cause of the problem.

Pain in the hip joint and radiating down the leg

If pain from a painful joint radiates to the groin, knees or buttocks, then the problem is most likely caused by damage to the nerve that innervates the leg area for one of the following reasons:

• joint volume
• infectious arthritis - occurs due to damage from a pathogen
• fracture of the femur (in the head or neck area)
• Legg-Calvé-Perthes pathology - necrosis of the cartilage tissue of the femoral head
• juvenile epiphysiolysis - disorder of the structure of the head of the joint and its inflammation

Pain in the hip joint, radiating to the leg, can signal pathologies of the cartilage tissue and peri-articular structures, lack of lubrication of the joint and damage to the synovial membrane. Painful symptoms may appear suddenly or gradually increase.

Pain when walking

Pain in the hip joint can occur when walking if the acetabulum comes into contact with the cartilage tissue of the femoral head, resulting in an inflammatory process. The cause of this phenomenon can be mechanical damage, inflammation of the anatomical formations located next to the joint.

Based on the intensity of pain in the hip joint when walking, you can determine the root cause of the problem:

• discomfort that appears at the beginning of walking, gradually subsiding - a sign of inflammation of the periarticular chest
• discomfort that gradually increases from the moment you start walking - inflammation of the articular surfaces of the hip joint
• constant pain of high intensity, accompanied by reduced functionality of the joint - occurs with dislocations and fractures
• the pain appears closer to the night - a consequence of the deformation of the cartilage of the femoral head and (or) the acetabulum, which rub against each other and become inflamed
• pain of moderate intensity is a sign of minor injuries and bruises

Pain when abducting the leg

Pain during abduction of the leg is caused by inflammation of the tissues and structures that provide movement: muscles, periarticular bursae, tendons. Similar symptoms often result from myositis (inflammation of muscle tissue), bursitis (inflammation of the periarticular bursa) and tendinitis (inflammation of the tendons).

Reasons

In most cases, pain in the pelvic area is caused by the patient having one of the following problems:

• arthritis
• coxal joint
• folliculitis of the trochanteric bursa
• tendonitis
• infectious pathologies
• hereditary diseases
• tumor formation in the pelvic area

Without timely treatment, each of these causes can lead to serious complications, including loss of joint mobility.

Arthritis

Arthritis (coxitis) is a disease of the joint tissue caused by disorders of the immune system or damage to pathogens: viruses and bacteria.

Symptoms of arthritis:

• increase in temperature
• pain and swelling in the joint area
• motor impairment

The disease occurs in acute, subacute and chronic form.

Coxarthrosis

Another name for coxarthrosis is osteoarthritis of the hip joint. This pathology is caused by metabolic disorders in cartilaginous tissues, resulting in their death. The cause of this phenomenon can be injury, reduced blood supply, excessive physical activity, age over 45 and heredity. The main symptom of coxarthrosis is pain in the lower back, groin and buttocks, which gradually increases during physical activity and leads to lameness. Discomfort is reduced during periods of inactivity.

Folliculitis of the trochanteric bursa

The presence of an inflammatory process in the bursa (trochanteric bursa) is characterized by the appearance of severe pain in the joint area. Athletes and the elderly are susceptible to the disease. The main symptom of trochanteric bursitis is pain in the area of the greater trochanter, which increases when you try to lean on the affected leg.

Tendonitis

Inflammation of the tendons is called tendinitis. This is a disease that occurs in acute or chronic forms and leads to degenerative changes in the tissue. Often the pathology appears in athletes who do not follow their running technique, as well as after a large load on the hip muscles.

Usually, tendinitis is a complication of another disease:

• thyroid pathology
• metabolic disorders
• arthritis
• arthropathy
• inflammatory process of systemic or infectious origin
• hip dysplasia

Tendonitis causes the patient discomfort with movement, pain, changes in gait and clicking when walking in the joint area.

Infections

Some infectious diseases cause inflammation in the tissues of the joint, as well as in nearby anatomical structures, resulting in severe pain in the hip joint. Most often, the following pathologies have similar symptoms:

1. Aseptic necrosis of the femoral head is a disruption of the blood supply to the groin, resulting in tissue death. The pain associated with this disease is sharp and intense. The problem is more common in men.
2. Suppurative arthritis is a serious disease that requires immediate treatment. If you don't get medical help right away, sepsis can occur. The relevant symptoms are general poisoning, pain and swelling in the area of the affected joint, difficulty in motor activity.
3. Tuberculous arthritis is common in children and is characterized by a slow progression. Associated symptoms are increased fatigue, decreased motor activity and muscle atrophy. Pain of varying intensity increases when a purulent abscess appears.

Infectious pathologies of the hip joint lead to serious complications and therefore require immediate treatment.

Hereditary diseases

Hereditary pathologies of the hip joint usually appear between 1 and 10 years of age, and are characterized by pathological changes in the tissue of the glenoid cavity and/or the femoral head. The most common inherited disease affecting the hip joint is Legg-Calvé-Perthes syndrome, which is characterized by pain and impaired walking due to the death of cartilage tissue in the joint.

Bone and soft tissue tumors

Benign or malignant bone and soft tissue growths in the hip joint can cause pain when walking or resting. The tumor can occur in bone tissues (osteomyelitis), in cartilaginous tissues (chondroblastoma, chondroma), in osteochondral tissues (osteochondroma). As a rule, neoplasms cause discomfort and are felt during palpation. Benign tumors are treated surgically, some of them can turn into cancerous tumors.

Soft tissue tumors of the thigh:

• lipoma
• rhabdomyoma
• fibroma
• hemangioma
• neuroma

An oncologist deals with the diagnosis and treatment of tumors in the hips and pelvis.

What to do

With severe pathologies of the hip joint, a person feels severe pain. Discomfort in the pelvic area is a reason to visit a medical facility for examination and treatment.

Particular attention should be paid to the intensity of the pain:

1. Lungs- appear with bruises after injury. Cold should be applied to the painful area to reduce swelling. To reduce pain, it is recommended to take a non-steroidal anti-inflammatory drug. It is recommended to consult a doctor.
2. Moderate- usually appear in diseases of the hip joint, accompanied by difficulty in motor activity and increased body temperature. Discomfort increases during physical activity. It is necessary to consult a rheumatologist.
3. Strong- occur due to dislocations and fractures. It is accompanied by limitation or inability of physical activity. In cases of severe pain in the hip joint caused by an injury, you should contact an ambulance.

There are many folk recipes that are used for pain in the hip joint. It is important to remember that all are suitable for symptomatic treatment and pain reduction, but will not help eliminate the cause of the problem. Effective treatment is carried out exclusively under the supervision of a qualified physician.

Which doctor should I contact?

If you have hip pain, you should contact your family doctor or general practitioner, who will refer you to a specialist. Diseases of the musculoskeletal system are treated:

• traumatologist— pain in the hip joint due to physical activity, sprains, falls and other injuries
• rheumatologist- sudden onset of joint pain for no apparent reason

You may also need to consult other doctors: surgeon, oncologist, infectious disease specialist, etc.

Diagnostics

The first important stage in the diagnosis of pain in the hip joint is the external examination, which necessarily includes taking a souvenir and palpation. Depending on the severity of the disease and the patient's complaints, laboratory tests and instrumental diagnostic methods are prescribed:

• x-ray- the use of X-rays to examine a specific area of the body
• CT and MRI- modern accurate diagnostic methods that allow you to get highly informative images of the joint and the area around it
• microbiological examination of a sample of biological materialallow the detection of the presence of pathogenic microorganisms: viruses and bacteria
• immune blood test- allows you to identify disorders of the immune system, determine the presence of certain autoantibodies
• arthroscopy (endoscopy)— examination using a probe, the possibility of taking a tissue sample of the joint for further research
• laboratory examination of the collection- taking a sample of intra-articular fluid during the puncture and identifying the causative agent of an infectious disease in it, checking for sterility

The use of several diagnostic methods in combination allows us to identify the cause of pain in the hip joint with high accuracy.

Treatment

The treatment of pain in the hip joint should be prescribed by a doctor based on the examination and diagnosis. As a rule, drug therapy or surgery is prescribed.

Medication

The treatment of pain in the hip joint must be comprehensive, aimed at eliminating the symptoms and most importantly, at eliminating the cause of the problem. For this purpose, drug therapy is used, which includes the use of:

• non-steroidal anti-inflammatory drugs- help reduce pain, relieve swelling
• means to improve microcirculation- help restore blood circulation and nutrition of joint tissues
• chondroprotectors- promotes the restoration of cartilage tissue
• muscle relaxants- reduction of pain, improvement of blood flow in the damaged area
• hormonal drugs- to relieve pain and suppress inflammation

In the treatment of pain in the hip joint, physiological procedures are particularly effective: massage, acupuncture, cryo- and laser therapy. Special therapeutic exercises and manual therapy are also used.

Surgical

Surgery is indicated in advanced cases when conservative treatment does not help the patient. This involves partial or total replacement of the affected joint with a prosthesis.

Prevention

Reducing the load on the legs will slow down the pathological processes inside the joint, so people who are obese are advised to start losing weight.

Preventive measures will help reduce pain in the hip joint:

• regular walking
• physiotherapy
• a balanced diet rich in vitamins A, C, E

Timely consultation with a doctor in the early stages of the disease increases the effectiveness of treatment and also reduces the risk of complications and serious consequences for the body.